SCN5A Variant A1428V Detail

We estimate the penetrance of LQTS for SCN5A A1428V around 2% and the Brugada syndrome penetrance around 51%. SCN5A A1428V was found in a total of 6 carriers in 2 papers and/or in gnomAD: 4 had Brugada syndrome, 0 had LQTS. A1428V is not present in gnomAD. A1428V has been functionally characterized in 3 papers. This residue is located in a Hotspot region for Brugada syndrome and a Non_Hotspot region for LQTS. In silico predictions, functional data (if available), and location in structure are equivalent to phenotyping 10 individuals for Brugada syndrome (4 diagnosed with Brugada syndrome) and 5 individuals for LQTS (0 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A A1428V around 2% (0/16) and the Brugada syndrome penetrance around 51% (8/16).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-3.8 1 -1.72 0.943 56 4
PROVEAN scores less than -2 are considered deleterious. REVEL scores higher than 0.5 or 0.75 are considered likely pathogenic (higher sensitivity with the former cutoff, higher specificity with the latter cutoff). A PolyPhen-2 score of 0.85 or greater is considered likely pathogenic. BLAST-PSSM reflects the evolutionary conservation of residue substitutions, more negative numbers indicate fewer observations of the specific substitution than is expected. Penetrance Density is our previously published method to calculate the average BrS/LQTS probability density in a shell of residues surrounding a residue of interest (Kroncke et al. 2019).

Reported Carrier Data

PubMed ID Year Carriers Unaffected LQT3 BrS1 Other Other Disease
28781330 2017 6 0 4 0
20129283 2010 1 0 1 0
LITERATURE, COHORT, AND GNOMAD: - 6 2 0 4 -
VARIANT FEATURES ALONE: - 15 11 0 4 - -
Summary totals might not agree with the literature table because of duplicate patients, which were excluded from the total counts. We do not distinguish here between multiple missense codons. Missense variants are combined across degenerate codon substitutions since codon-level data were not consistently available for curation.

Functional Data

Peak and late/persistent current are relative to wildtype (100% being no different from wildtype). V0.5 act/inact are the voltages at which half of the maximal current is reached during an activation and inactivation protocol, each is in units of mV and relative to wildtype.
PubMed ID Year Cell Type Peak Current (%WT) V1/2 Act. (mV) V1/2 Inact. (mV) Late/Persistent Current (%WT)
20129283 2010
32533946 2020 HEK 0
28781330 2017

A1428V has 67 previously observed neighbors within 15 angstroms

A residue within a folded protein on average has nearest neighbors that fall roughly into two shells: a "nearest" neighbor around 5-6 angstroms and a second shell around 11 angstroms. All variants shown in the rightmost column have been observed in at least one individual in the literature or gnomAD.

Neighbor Distance (Angstroms) Variants Observed in Individuals
1355 9
1403 12
1357 11 A1357V,
1430 5 D1430N,
1352 10
1426 7
1445 11 Y1445H,
1453 13
1361 10
1447 10
1444 9 L1444I,
1351 13 M1351V, M1351R,
1440 11 W1440X,
1397 13 c.4189delT, c.4190delA,
1449 9 Y1449C, Y1449S,
1452 15
1380 15 N1380K, p.N1380del,
1429 4
1442 11 Y1442C, Y1442N,
1450 8
1398 10 V1398M,
1411 11
1451 13 V1451L, V1451D,
1353 13 V1353M,
1407 14
886 14 H886P, H886Q,
1358 11 G1358W, G1358R,
1362 10 c.4083delG, R1362S,
1433 10 G1433R, G1433W, G1433V,
1438 9 P1438L,
1348 15 F1348L,
1423 9 D1423H,
1437 12
1349 14
1431 5 S1431C,
1422 10 M1422R,
1359 7 K1359N, K1359M,
1434 12 Y1434X, c.4299G>A, c.4299+1G>T, c.4299+2T>A, c.4300-1G>A, c.4299+1delG, c.4299delG, c.4299_4300insG, c.4300-2A>T, c.4299+28C>T,
1356 6 c.4066_4068delTT,
1412 12 L1412F,
1408 13 G1408R,
889 13
1420 12 G1420V, G1420D, G1420R, G1420P,
1360 6 F1360C,
1401 10
1425 6
1399 15
1454 15
1354 14
1427 4 A1427E, A1427S,
1446 8
1424 7 I1424V,
1432 11 R1432G, R1432S,
1448 12 I1448T, I1448L,
1439 11 Q1439R, Q1439H,
878 12 R878C, R878H, R878L,
1400 11 V1400I,
1421 11
885 14
1443 8 N1443S,
1441 13 E1441Q,
879 12 W879R,
1415 12
1428 0 A1428V, A1428S,
1436 14
1414 14 Q1414H,
1402 9